Liberia was the second country to confirm cases of Ebola when the outbreak was announced in March of this year. In a few short weeks, the number of cases and fatalities sky-rocketed form single to triple digits. To date, Liberia has been hit the hardest of any of the affected countries, with over 1000 suspected cases, and over 600 fatalities, consistent with the nearly 60% mortality rate of this particular strain of ebolavirus.
Tensions mounted in the last few months, as a number of cases were discovered in Monrovia, Liberia’s capital. A treatment facility for suspected Ebola cases was set up in West Point, a township of Monrovia, however, locals were angered that infected patients were being brought into their community from other parts of the city. On August 16, armed men attacked the clinic and looted infected medical equipment and bed linens, causing patients to flee. While some of the patients were later found and brought to a hospital in Monrovia, other remained missing.
On Wednesday, August 20th, heavily armed police and military personnel arrived at West Point, which rests on a peninsula on the outskirts of Monrovia, and proceeded to barricade the entire slum with barbed wire, cutting it off from the rest of the city. Only the family members of a politician, escorted by police firing live rounds, were allowed to leave. As she announced the quarantine of West Point and the neighboring slum Dolo Town, President Ellen Johnson Sirleaf cited, among other reasons, people’s “disregard for the advice of health workers and disrespect for the warnings by the government.”
The purpose of a quarantine is to contain or isolate a high risk individual or group until the risk of their contaminating the general population can be mitigated. At first glance, this might seem like a necessary, if distasteful, response to the attack on the health clinic and subsequent risk of spreading Ebola in West Point. With no waste disposal and running water, and open sewage running in the streets, densely populated West Point is a time bomb for an infectious disease like Ebola. The community also has a culture of mistrust for the Liberian government, which combined with a lack of understanding about Ebola, hinders public cooperation with government efforts.
But West Point is not a small neighborhood: the slum is home to well over 50,000 people. That is, 50 times the number of suspected cases of Ebola in the entire country since the initial outbreak. Such extreme quarantine measures haven’t been used since the 1800’s. Officials of the World Health Organization and CDC say that such measures could help prevent the further spread of Ebola, provided that they are used humanely. Unfortunately, the “quarantine” of West Point has fallen far short of this ethical stipulation. These barbed-wire enclosed areas might be better named concentration camps than quarantine zones.
Rather than aggressively address the lack of running water, sanitation and education that make West Point so susceptible to the spread of Ebola, the government of Liberia has instead chosen to cut off all movement of people and goods into and out of the area, with the exception of government rice and water rations that are not sufficient to feed the population. Adding a food and water shortage to the rest of West Point’s risk factors will exacerbate the problem exponentially: President Ellen Johnson Sirleaf and the Liberian government are effectively sentencing 60% of the population of West Point to death.
If and when the Ebola epidemic begins explode inside of West Point, the tension and panic that are already spurting up will come to a head. (Already police open fired on protesters, injuring, among others, a 16 year old boy who later died from his wounds.) Barbed wire will not be capable of containing 50,000 terrified people, and when they breach the barrier, the rest of Monrovia and Liberia will be much worse off than if the citizens of West Point had been treated with the same dignity and concern for loss of life that is prompting the government to take such drastic measures to protect the rest of Monrovia.
In the midst of this terrifying epidemic, I don’t doubt that the government of Liberia will do everything in it’s power to protect its citizens from the further spread of Ebola. But if the government treats the well-being of the residents of a slum as secondary to the well-being of the rest of the population, then they have lost the battle before it’s begun. After all, the people in these slums are citizens of Liberia.